McCall Louise, Clarke David M, Rowley Glenn
Department of General Practice, Monash University, Victoria.
Aust Fam Physician. 2002 Mar;31(3):299-303.
Attitude, together with knowledge, is important in determining behaviour. Doctors' attitudes affect the recognition and management of mental health. We detail the development of an instrument to measure general practitioner attitudes to the recognition and management of depression and anxiety disorders.
A literature review and semistructured interviews with GPs identified constructs for inclusion into the questionnaire. Items were written and examined by a panel of psychiatrists, GPs and statisticians to establish face and content validity. The resulting 30 item questionnaire was given to a convenience sample of 63 GPs in Australia with an interest in mental health, and their responses analysed using exploratory factor analysis.
Exploration of the data identified two factors. Factor 1 contained 12 items measuring professional comfort and competence with the care of mental health disorders (alpha = 0.82). Factor 2 contained five items that assessed GP concerns about difficulties with the health care system in this area (alpha = 0.73).
The factor analysis shows that GPs' attitudes can be parsimoniously described by two factors, instead of the five that the literature suggests. The high values of Cronbach's alpha demonstrate that these two factors can be measured reliably. These were not the anticipated results, and can be taken to indicate that GPs' attitudes to their roles in the recognition and management of patients with depression and anxiety disorders are less complex than might otherwise be imagined.
态度与知识一样,在决定行为方面很重要。医生的态度会影响对心理健康的认知和管理。我们详细介绍了一种用于测量全科医生对抑郁症和焦虑症认知与管理态度的工具的开发过程。
通过对全科医生进行文献综述和半结构化访谈,确定纳入问卷的结构。由一组精神科医生、全科医生和统计学家编写并审查题目,以确立表面效度和内容效度。将最终形成的30个题目的问卷发给澳大利亚63名对心理健康感兴趣的全科医生组成的便利样本,并使用探索性因素分析对他们的回答进行分析。
对数据的探索确定了两个因素。因素1包含12个题目,测量对心理健康障碍护理的专业舒适度和能力(α = 0.82)。因素2包含5个题目,评估全科医生对该领域医疗保健系统困难的担忧(α = 0.73)。
因素分析表明,全科医生的态度可以由两个因素简洁地描述,而不是文献中所建议的五个因素。克朗巴赫α系数的高值表明这两个因素可以可靠地测量。这些并非预期结果,可以据此表明全科医生对其在抑郁症和焦虑症患者认知与管理中角色的态度比原本想象的要不复杂。